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Life Planning #1/ Put Your
House In Order



 Philip Lisagor, MD, FACS
 www.TheROYL.com
Where Are We?
   10,000 Americans turn 65 every day and this
    will continue until 2031
   This encompasses 78 million Americans born
    between 1946 and 1964/ aka Baby Boomers
   Baby Boomers are currently taking care of their
    parents and often of their children in todays
    economy
   One in 5 Americans have advanced directives,
    and 1 in 5 of them have it available for 1/25
Where Did We Come From?
   Egyptians, at least the wealthy, planned
    for their deaths in advance
Ancient Hebrew Patriarchs
So did the Hebrew Patriarchs: Abraham,
 Isaac and Jacob
Greek Thoughts
 Greeks had Hades, abode of the dead
 Charon, ferryman, for the River Styx
 Coin placed in mouth of the dead to pay
  Charon
How Did We Get to Today?
 Dissolution of extended family
 Belief in science and medicine
 Evolving complexities of everything!
How Did I Get Involved?
 MD 72, University of Chicago
 Career in surgery/ general, thoracic,
  cardiac including thoracic oncology
 That means lung cancer!
 Long trip to actually talking with patients,
  their families and loved ones
Why Dont Doctors Talk to
Patients?
   Not trained
       Had seminar with Elizabeth Kubler-Ross in Medical
        School, Of Death and Dying 5 steps of Grief
   Uncomfortable
       Dealing with failure
       Dealing with their own mortality
       Feeling they have nothing to offer
   Takes time and isnt included in government or
    insurance billing codes
Ostrich Effect
Development of ROYL
 Rest of Your Life planning
 Toolkit for Doctors
 Aimed an End of Life Planning
 Expansion to Stakeholders
 Expansion to Rest of Your Life planning
Benefits of ROYL
 Improved quality
 Improved patient/family/loved ones
  satisfaction
 Reduced cost of health care
     US #1 in cost
     US #7 in benefits

     Growth not sustainable (16% GDP currently)
Risks of Failure to do ROYL
 Decreased quality
 Decreased satisfaction
 Increased costs-50 billion/year
 Someone will do planning for you, loss of
  patient autonomy
 Death panels argument
     Why?
     Who?
ROYL
 Legal documents
 Personalized information sheets
 Personalized process action check list



Cultural Change-possible with current
 economic imperative of the graying of the
 boomers!
WWW.TheROYL.com

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  • 1. Life Planning #1/ Put Your House In Order Philip Lisagor, MD, FACS www.TheROYL.com
  • 2. Where Are We? 10,000 Americans turn 65 every day and this will continue until 2031 This encompasses 78 million Americans born between 1946 and 1964/ aka Baby Boomers Baby Boomers are currently taking care of their parents and often of their children in todays economy One in 5 Americans have advanced directives, and 1 in 5 of them have it available for 1/25
  • 3. Where Did We Come From? Egyptians, at least the wealthy, planned for their deaths in advance
  • 4. Ancient Hebrew Patriarchs So did the Hebrew Patriarchs: Abraham, Isaac and Jacob
  • 5. Greek Thoughts Greeks had Hades, abode of the dead Charon, ferryman, for the River Styx Coin placed in mouth of the dead to pay Charon
  • 6. How Did We Get to Today? Dissolution of extended family Belief in science and medicine Evolving complexities of everything!
  • 7. How Did I Get Involved? MD 72, University of Chicago Career in surgery/ general, thoracic, cardiac including thoracic oncology That means lung cancer! Long trip to actually talking with patients, their families and loved ones
  • 8. Why Dont Doctors Talk to Patients? Not trained Had seminar with Elizabeth Kubler-Ross in Medical School, Of Death and Dying 5 steps of Grief Uncomfortable Dealing with failure Dealing with their own mortality Feeling they have nothing to offer Takes time and isnt included in government or insurance billing codes
  • 10. Development of ROYL Rest of Your Life planning Toolkit for Doctors Aimed an End of Life Planning Expansion to Stakeholders Expansion to Rest of Your Life planning
  • 11. Benefits of ROYL Improved quality Improved patient/family/loved ones satisfaction Reduced cost of health care US #1 in cost US #7 in benefits Growth not sustainable (16% GDP currently)
  • 12. Risks of Failure to do ROYL Decreased quality Decreased satisfaction Increased costs-50 billion/year Someone will do planning for you, loss of patient autonomy Death panels argument Why? Who?
  • 13. ROYL Legal documents Personalized information sheets Personalized process action check list Cultural Change-possible with current economic imperative of the graying of the boomers!